Sickly McSick face
April 4, 2017 8:14 PM   Subscribe

I have been getting sick with alarming frequency this year. Please help me talk to my doctor about this.

Since September, I have been sick eight times. For some background context, basically, I am a clusterfuck of ENT problems. I've been diagnosed with silent reflux. I have a mysterious chronic cough that may or may not be asthma. I don't wheeze and I tested normal on the spirometry, but it's very responsive to Flovent, so it may be cough-variant asthma. No one has told me for sure, which is mildly frustrating, but anyway.

I have been tested for allergies: all negative. I have seen two different ENT's now. The first one told me I had "chronic inflammation" in my throat and there's nothing he can do, so he was fired. The second put me on a stronger reflux medication--Dexilant--and told me my adenoids were so big they were almost obstructing my nasal airway. A different doctor--his colleague--removed them almost a month ago. More on that below. I had a CT scan of my sinuses two years ago, which was normal, but I haven't had one since.

My tonsils are "cryptic" and the second ENT said they would flare-up every 4-6 weeks, but he didn't think they had to be removed. My throat feels really bad right now--not HURTING but very irritated--so perhaps this is what he was talking about. I have not tried an elimination diet but I plan on doing so; I really think it would be a good idea. Every ENT I have seen this year has remarked on the volume of secretions I am making. It looks like a river. I have seen it.

I'm struggling to remember any more background information right now. I'll update if I think of anything.

In order, I have had:
A high fever turned bad cold turned ear infection in September--needed antibiotics.
A standard head cold in September/October
A random flu-like fever thing for a couple days in mid-October

Then my cough/asthma started flaring up BAD. This was in November (when it always flares up honestly). The doctor gave me an inhaler and put me on an antibiotic to be safe, which made no difference.

At the end of December I got a sinus infection--like a legit one that was getting steadily worse over ten days--needed antibiotics.
At the end of January I got a bad stomach virus.
In February I got another cold that turned into an ear infection--more antibiotics.

Then, in March, I had my adenoids removed. Yay! Surgery was unremarkable until a week later, when my scab broke and I spat up a large volume of blood over breakfast. Yikes. I already had chest congestion after the surgery, but after the scab broke it got a LOT worse.

Then, a week later (last week), I got sick again with something that made me feel like I had been hit by a truck. I was also producing this brown goop of horror which came out of my nose or mouth once every hour or so. I felt like I had been hit by a truck and could not breathe. I got another antibiotic, and my GP gave me prednisone, yay. I started feeling better but I'm still producing some god-awful sinus glue of horror. It's hard and tastes like bleach. I think it's getting less.

Now, however, my throat feels really irritated, and I think I'm getting another cold.

So, uh, yeah, that's been an ordeal. Some possible mitigating factors: I work with young children. I am a vegetarian. I have been stressed, but not overly so. PLEASE NOTE that I have been working with young children for YEARS, and I have never gotten sick even CLOSE to this much. I typically get sick MAYBE five times a year. I have always thought I get sick more than the average person and this just takes it to a whole other level. I have never been this sick in my life. My boss is at her wit's end; she told me I must be doing too much and is cutting my hours back as much as she can.

I need to talk to my doctor. What do I say? She knows I've been sick a lot but she doesn't know the extent. A lot of the times I just stayed home and suffered through it. I was going to send her a message through our patient portal thing, telling her that I'm wondering if I have some kind of nutrient deficiency, and should I go see her or does she just want to order bloodwork or ???

I know I need to advocate for myself--young females are really severely brushed off by doctors--but I just don't know where to begin.

Thanks in advance.
posted by Amy93 to Health & Fitness (12 answers total) 5 users marked this as a favorite
Have you seen an allergist/immunologist? I saw one after years and years and years of a frustrating breathing issue and she diagnosed it in 30 minutes using systematic testing and then told me how to fix it and it worked. It was a fucking miracle. But what was nice was she was versed in really everything relevant, which the 3 or 4 ENTs I saw previously clearly were not, being more surgeons who did some guessing on the side that anything approaching diagnosticians.
posted by fshgrl at 9:42 PM on April 4, 2017 [1 favorite]

Assuming you've been seeing your own doctor for all these things, you could just ask if she thinks there is anything unusual about the pattern this year, and then ask if there's anything she would recommend prevention wise.

However, I think you should be prepared to hear that she thinks you've just had a run of bad luck with infections lately, and be open to considering that it may be the truth and not anything to do with getting brushed off. The fact that you had a head cold in September most likely isn't related to having a stomach virus in January. The vast majority of the time people get things like head colds, ear infections, sinus infections and stomach bugs, it's because they were exposed to the virus/bacteria and not any kind of underlying issue with their immune system. Also, when you have asthma, that tends to make upper respiratory infection symptoms last longer and potentially have a worse impact on you, so perhaps the asthma is part of the reason you're feeling worse this season versus others - maybe it's not as well controlled as it could be. Your doctor is probably in the best position to tell you more about the relevance of that, and should certainly also be able to clarify for you whether you do have a diagnosis of asthma or not.

I think this would be a question better asked in person, although I don't think you necessarily need to make an appointment just to ask it - but it is not a straightforward question and so probably not easily answered through the patient portal.

Side comment - you mentioned that you needed antibiotics several times in the past 6 months. That may be true (no way to know from the level of detail provided), but I would note that antibiotics are heavily overused in situations where they are likely unnecessary, particularly upper respiratory infections/sinusitis - not just by bad doctors, but almost every doctor probably prescribes some unnecessary antibiotics at times (i.e. 'to be safe') just because it's not always clear cut when people need them, and patients are usually happier to get antibiotics than to be told that they probably have a virus that nothing will help with but time. I'm not sure if that is reassuring or just frustrating to hear, but getting antibiotics for these kinds of illnesses isn't necessarily an indicator of severity.
posted by treehorn+bunny at 11:55 PM on April 4, 2017 [4 favorites]

Have you had your vitamin D levels checked?

I used to be you, every winter, then a sinus infection that they finally took seriously meant that they happened to check my levels. Once I started taking the prescription supplement, it changed my life.
posted by greenish at 1:37 AM on April 5, 2017 [2 favorites]

Whether you use the patient portal or go directly to a visit, bring your written list with you - maybe bullet-point it or make each entry short and easily scannable. I find it's easier to advocate for myself properly when I can say "hey, I made a list so that I'd be able to remember everything for you", rather than starting to list it out and losing the focus a bit, or losing the impact when it starts to sound "and then...". My doctor is great and I would usually hand him the list directly, but you'll know what's most appropriate.

Your outcome might be the same, but at least you can be sure the series of events that's worrying you is clearly visible to the doctors too.
posted by carbide at 5:34 AM on April 5, 2017 [1 favorite]

Also chiming in to ask if your vitamin D levels have been checked. I had a fall/winter where I was knocked flat by every bug that came within a 100 mile radius. I was less than a year out from having my first kid, working full time in a pediatric care environment and just chalked it up to stress and lack of sleep and daycare germs. Once I finally got to the doctor, my vitamin D levels were basically at the floor of the test. A few weeks of supplements and I felt like a new person.
posted by goggie at 7:53 AM on April 5, 2017

seconding treehorn+bunny to make sure you find out about whether you do indeed have asthma, and if you do, work on controlling it well.

Also, did you get a flu shot this year? (If not, with your issues, I would recommend you get one yearly).

When I got cellulitis a few times in one year, my doctor and I began to wonder if there was not some underlying thing out of whack with my health. I was also getting colds/flu a lot, despite getting a flu shot and despite getting allergy shots to treat my various allergies. We were sort of running out of ideas, and then my doctor's Physicians Assistant pointed out that my thyroid levels were a bit low ... though not low enough where you would normally treat it usually (in retrospect I was having some symptoms that could be ascribed to low thyroid). So when my doctor and I talked, I said - how about trying a low dose of synthroid/thyroid medication, since we had tried everything else! Well, that did the trick, and I have not had cellulitis since, and with the added bonus of a general improvement in my overall health, a lot fewer colds, and feeling better than I have in years.

I'm telling this story not to suggest that you try thyroid medication, but to suggest that you take a look at your overall health in detail, and if there is anything that might need improvement then try that, including even basic stuff like eating right, getting enough sleep, vitamins, lots of handwashing when working with the kids, and after coming home from public places, etc., etc..

So, to start, in addition to the asthma question, if I were you, I would ask your GP to do some blood work, and to use that to check your iron, Vitamin D, Vitamin B12, thyroid levels, etc., just to see if there is anything that might need to be addressed.
posted by gudrun at 8:07 AM on April 5, 2017 [4 favorites]

I think you should definitely make a timeline of all these things that have hit you, and print it out and bring it. (In my mind, it's like 3 pages taped together that you have to unfold like a banner - you've really been through the wringer!) Probably the first thing that happens is bloodwork, when the results come back you can have a more in-depth conversation about next steps.
posted by Lyn Never at 8:34 AM on April 5, 2017

Yes to all the above tests. Also, have you heard of nonallergic rhinitis? It is a condition that mimics the symptoms of allergies, but sufferers test negative for allergies. If you have chronic postnasal drip and you have tested negative for standard allergies, it might be something to ask about.
posted by zoetrope at 9:15 AM on April 5, 2017 [1 favorite]

Have you considered a fungal issue? There's a condition called allergic fungal rhinosinusitis in which mean age of diagnosis is quite low (22) and is diagnosed after other sinus treatments such as antibiotics or surgery fails. Mucous is thick like "peanut butter or axle grease." People can present with symptoms without a history of allergies and antibiotics are known aggravate fungal problems at times. But I am just a piddling googler with no medical training whatsoever so go to a doctor/specialist (obviously).
posted by wilywabbit at 5:53 PM on April 5, 2017

Also, silent reflux lowers the immune response so getting the symtoms of your primary illness under control will surely help. Also nthing vitamin D and the elimination diet (wheat and dairy especially ).
posted by wilywabbit at 7:52 PM on April 5, 2017

Wow, I almost feel like I could have written this post, and I did indeed have very low vitamin D and slightly low B and thyroid last fall right before I started getting sick, or possibly during my first illness. For what it's worth, I had my adenoids out when I was a teenager and it made a HUGE difference in my health/allergies, and I was just today wondering out loud if I should have my tonsils checked. Did your ENT say anything about a deviated septum? Mine is apparently bad enough to need surgery, and I may be finally reaching the end of my rope after this year of illnesses. FWIW, I usually spend 3-6 months a year with sever sinus infections that leave me coughing so much that I cannot talk. Usually, I get a cold, then it turns into a sinus infection, then I try to fight it off for a couple of months, give in and get an antibiotic prescription, recover quickly(ish) and stay well until the next time someone in my family gets a cold and then it all starts over again. This year, though, I guess I finally got good enough at washing my hands that I didn't get a cold multiple times. And I still got this damn sinus infection anyway. More than once. I have just given in after THREE rounds of antibiotics since last fall (each time delaying for more than a month, and the final time for a damn UTI that I tried to treat with OTC meds for a month because have you heard? Antibiotics are over prescribed, and you shouldn't just take them willy nilly). Just today, with YET ANOTHER sinus infection cough, and being completely unwilling to do yet another round of antibiotics, I finally started the prednisone my doctor prescribed. (I'd been trying to avoid it because I've had a bad reaction before.) I am at my wits end, totally miserable, and feeling very sorry for myself. Though I suppose it's possible that's the prednisone 😛 as that's one of the side effects I've had in the past. Anyway, one thing I am trying now is an elimination diet. From what I've read, dairy and wheat are pretty common causes of sinusitis, and I've noticed improved sinus pressure/clearer sinuses when stopping dairy in the past. If that doesn't work, maybe I'll check into the fungal thing someone mentioned above.

I hope you recover soon and have fewer illnesses next year. Repeated illness is SO draining, I wouldn't wish it on anyone.
posted by instamatic at 7:25 PM on April 8, 2017

Also, regarding fshgjrl's note about allergist/immunologist, it was my kids' allergist who initially rediagnosed my "allergies" as chronic sinus infections (triggered by a combination of colds and allergies), which was totally life-changing. It's MUCH better to be sick 3-6 months a year than 6-9 months, which was more common before I started taking antibiotics. (FWIW, I always wait at least 4 weeks from onset of illness before starting antibiotics, because I want to be very certain I'm treating the sinus infection caused by the virus rather than the virus itself. My doctor does not totally approve of this; she thinks I wait too long to get treatment.)

Today in my prednisone-induced pity party, I may or may not have resolved to give up sugar forever, and also start Crossfit, if only I'd be healthy again. It's like negotiating with a vicious ancient god. Next, I'm offering to sacrifice my tonsils and also possibly my sense of smell. (The reason I postponed nasal surgery is that a friend was similarly diagnosed at the same time as me, and had one of those disastrous nasal surgeries that left her needing more surgery and also I think unable to smell. Scary.)
posted by instamatic at 7:45 PM on April 8, 2017

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